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Individual
TIMOTHY J WYNN
Active
Individual
TIMOTHY J WYNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
3552761
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0680151
—
OH
01
—
110096034
RAILROAD MEDICARE PIN
OH
Enumeration date
06/06/2006
Last updated
12/29/2008
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